Eating Disorders & LGBTQ Community: Treatment Best Practices
From Walden Behavioral Care
What research tells us
The COVID-19 pandemic has increased the diagnoses of eating disorders in people under 30 by 15 percent in 2020 compared with previous years according to a recent study. While eating disorders affect people of all genders, ages and ethnicities, some groups are particularly susceptible. According to the Trevor Project National Survey, LGBTQIA2s+ folxs are 50 percent more likely to develop an eating disorder or die by suicide.
A 2015 study published in the Journal of Adolescent Health revealed that an eating disorder diagnosis is highest among individuals who identify as transgender, and higher still among people who identify as a sexual minority (i.e. lesbian, gay, bisexual) when compared with heterosexual women who identify as women (i.e. cisgender females).
These heartbreaking statistics speak to the magnitude of treatment for mental health needs in the queer community. And sadly, when it comes to mental health, there continues to be an inaccurate dominant narrative that only certain bodies get eating disorders, when in fact LGBTQIA2s+, BIPOC and AAPI people are more likely to develop an eating disorder than this narrative would suggest.
Where we fall short
Despite this, there’s little evidence-based research on effective treatment practices for this population, sometimes making it difficult for healthcare providers to meet the distinct needs of the LGBTQ+ community.
Additionally, many providers lack adequate knowledge of the unique issues faced by LGBTQ+ people, such as life stressors due to marginalization, the ways in which bodies and identities intersect, and the importance of establishing outpatient providers that are welcoming and educated about their specific needs.
How to build inclusive treatment environments
Inclusive treatment environments – built on knowledge, respect, empathy and understanding for everyone – are imperative. Based on my work as an eating disorder specialist, and my own experience as a member of the LGBTQ+ community, I’d like to share a few tips:
1) Develop cultural humility. Cultural humility is an “ability to maintain an interpersonal stance that is other-oriented (or open to the other)” and should be viewed as an evolving concept. Seek to increase your personal understanding through self-education so as not to tokenize a person or group of people. We can act equitably by reading books, blogs and pausing in conversation to make room for other, perhaps-less often-heard, voices.
2) Include names and pronouns during introductions. This not only applies to clients, but to ourselves and our colleagues. By introducing ourselves using names and pronouns and asking the name and preferred pronouns of those we meet, regardless of whether they choose to answer, we sidestep treating people differently based on our own assumptions and biases.
3) Properly identify gender neutral spaces. Although gender-neutral bathrooms are becoming more common in workplaces, college campuses and other public areas across the U.S., more can be done. Explicit signage such as gender-neutral bathroom markers, rainbow decals, or transgender flags is highly encouraged. They communicate a welcoming and safe space for all types of individuals.
4) Host regular trainings. Knowledge is powerful in creating inclusive settings. There are many great organizations offering workplace trainings, some free of charge. This includes a local chapter of Gay, Lesbian, and Straight Education Network (GLSEN) of PFLAG, or a local college or university’s LGBTQ+ center.
Change is a process. Signage, training and self-education are all great places to start though not an ending point. A more complete list of best practices on working with LGBTQ+ populations as recommended by the APA (American Psychological Association) is another resource for continued improvement and inclusivity.
Walden’s Rainbow Road
To help our industry begin to address the disparities for the LGBTQIA2s+ community, Walden Behavioral Care recently launched Rainbow Road, an IOP that addresses the specific needs and challenges of this population in terms of body image, relationships, and the social cultural trauma experienced being queer in an often-hateful world.
Rainbow Road is the first of its kind in the country in terms of eating disorder treatment for queer clients, by queer and allied providers who have a deep understanding of intersectional therapy and the nuances needed to work with this population in a way that is affirming and creates sustainable recovery.
We are proud to be modeling what the new societal expectation should be for mental health and eating disorder treatment providers and programs, and how to compassionately care for people of all genders and sexualities.
If you’re interested in learning more about our Rainbow Road IOP, Walden is here to help you. Contact us today and tell your evaluator that you are interested in Rainbow Road.
Author M Reim Ifrach (They/Them) is the Director of Rainbow Road IOP for Walden Behavioral Care. Their credentials include: REAT, ATR-BC, LPC. M is on the Board of Directors for Project HEAL and a contributor to the Museum of Modern Art’s “Artful Practices” Program. When M is not seeing clients, they teach Masters Level students on Diversity Practice in Art Therapy, Eating Disorders and Gender Affirming Care. M’s passion lies deeply with the LGBTQIA2S+, BIPOC+ and AAPI communities and seeks to expand mental health care to be more inclusive of all those with marginalized identities and barriers to treatment.